Sleep, Depression, and Stress Influence Weight Loss

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A new study suggests that sleep, depression, and stress are key components

of an interventional weight loss program. The study was published online

March 29 in the *International Journal of Obesity*.

The current US obesity epidemic is believed to have a number of contributing

elements, including genetic, environmental, and lifestyle factors, such as

disordered sleep patterns. Multiple studies have demonstrated an inverse

association between sleep duration and weight gain.

To better understand the effects of sleep, screen time, depression, and

stress on weight loss success, the researchers, led by Dr. Elder of

the Kaiser Permanente Center for Health Research, Portland, Oregon,

conducted a 2-phase randomized clinical trial. Phase 1 included a

nonrandomized, 6-month behavioral weight loss intervention that included 472

adults with obesity (body mass index, 30 - 50 kg/m2). Phase 2 incorporated

weight loss maintenance. The current study focuses on phase 1 results.

The phase 1 intervention included 22 group sessions, led by a behavioral

counselor, during the course of 26 weeks. Participants were given

recommendations to reduce food consumption by 500 calories per day, adopt

the Dietary Approaches to Stop Hypertension pattern, and participate in at

least 180 minutes of exercise per week.

Mean weight loss during phase 1 was 6.3 ± 7.1 kg, and 285 participants (60%)

who lost a minimum of 4.5 kg were randomly selected into phase 2.

Participants attended an average of 73.1% ± 26.7% of sessions. They filled

out 5.1 ± 1.9 daily food records per week and reported 195.1 ± 123.1 minutes

of exercise per week.

Stress and sleep time were revealed to be important factors in qualifying

for phase 2. A 1-point change in the Perceived Stress Scale had an

associated odds ratio of 0.966 (increased success associated with less

weight loss, 95% confidence interval, 0.937 - 0.995; *P* = .024).

Participants with a quadratic trend in sleep time had an odds ratio of 0.797

(95% confidence interval, 0.649 - 0.978; *P* = .030). Participants who slept

6 to 7 hours or 7 to 8 hours were more likely to qualify for phase 2 than

those with other sleep times.

At entry into the program, lower stress was associated with greater ensuing

weight loss (slope, 0.132; SE, 0.054; *t* = 2.42; *P* = .021).

Changes in baseline predictors during the program had significant impacts on

success. Reduction in stress between entry and a post weight-loss follow-up

visit as measured by the Perceived Stress Scale were associated with

improved weight loss (*r* = 0.159; *P* = .048). A similar trend was seen in

depression as measured by the Personal Health Questionnaire--Depression

Subscale (*r *= 0.223; *P* = .035).

The researchers found no correlation between screen time and weight loss

success. Session attendance correlated positively with weight loss success (

*r *= -0.621), as were exercise (*r* = -0.361) and food records (*r* =

-0.501; all *P* < .001).

" [These] results suggest that clinicians and investigators might consider

targeting sleep, depression and stress as part of a behavioral weight loss

intervention, " the study authors conclude.

*This work was funded by the National Center for Complementary and

Alternative Medicine, National Institutes of Health. The study authors have

disclosed no relevant financial relationships.*

*Int J Obesity. *Published online March 29, 2011.

Abstract<http://www.nature.com/ijo/journal/vaop/ncurrent/abs/ijo201160a.html>

www.medscape.com

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

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